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Cone Beam Computed Tomography: A 3D Revolution in Extremity Imaging

On 01/05/2018
Article viewed 222 times

Cone Beam Computed Tomography: A 3D Revolution in Extremity Imaging

By François Lintz in category IMAGING
Chirurgien Orthopédiste, Centre de Chirurgie de la Cheville et du Pied, Clinique de l’Union - Saint Jean, Toulouse

When Wilhelm Conrad Roentgen discovered radiography in 1895, he wrote in his diary, ‘I have discovered something interesting, but I don’t know if my observations are correct’.
He was doubly right. Two-dimensional radiography revolutionised medicine exactly one century ago, in that, formerly blind orthopaedic surgeons were finally able to open one single eye and marvel at the in vivo skeleton.

Introduction

When Wilhelm Conrad Roentgen discovered radiography in 1895, he wrote in his diary, ‘I have discovered something interesting, but I don’t know if my observations are correct’.

He was doubly right. Two-dimensional radiography revolutionised medicine exactly one century ago, in that, formerly blind orthopaedic surgeons were finally able to open one single eye and marvel at the in vivo skeleton. However, their vision was still astigmatic, because although radiography led to an unprecedented breakthrough in the exploration of the in vivo skeleton, the images obtained will never be more than projections subject to a number of biases and will remain an inaccurate and partial representation of reality.

With the advent of computed tomography (CT) imaging, the skeleton could finally be observed in three dimensions, but only in non-weight-bearing patients. Thus, by combining both imaging techniques, the surgeon could imagine more precisely what the surgical site would look like. This combination remained limited, on the one hand, by the limited capacities of the human brain (including orthopaedists’ brains) and by the resultant radiation dose. Today, thanks to the weight-bearing images produced by cone beam CT, we can finally see the skeleton clearly and with both...

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